基于决策曲线分析超声造影血流灌注参数评估PHC介入治疗后肿瘤活性的价值  

The Value of CEUS Perfusion Parameters Based on Decision Curve Analysis in Evaluating Tumor Activity in PHC Patients after Interventional Therapy

作　　者：于艳艳[1] YU Yan-yan(Department of Ultrasound Medicine,Huaihe Hospital of Henan University,Kaifeng 471000,Henan Province,China)

机构地区：[1]河南大学淮河医院超声医学科,河南开封471000

出　　处：《罕少疾病杂志》2025年第3期97-99,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨基于决策曲线分析超声造影(CEUS)血流灌注参数评估原发性肝癌(PHC)患者介入治疗后肿瘤活性的价值。方法 采取回顾性研究,选择2022年5月至2023年5月医院收治行经肝动脉插管化疗栓塞术(TACE)的86例PHC患者临床资料作为研究对象,采用数字减影血管造影(DSA)观察患者病灶染色情况并分组,将病灶仍存在肿瘤染色的PHC患者临床资料纳入残留组,将病灶完全灭活的PHC患者临床资料纳入灭活组。比较两组基线资料、CEUS血流灌注参数;采用受试者工作特征曲线(ROC)曲线评估CEUS血流灌注参数预测PHC患者介入治疗后肿瘤活性的价值;采用决策曲线分析CEUS血流灌注参数评估PHC患者肿瘤活性的价值。结果 介入治疗1个月时,PHC患者中肿瘤残留37例,肿瘤灭活49例,残留组病灶直径长于灭活组,残留组child-pugh分级为B级、病灶≥2个、有饮酒习惯患者占比高于灭活组(P<0.05);残留组达峰时间、增强时间、始退时间、廓清时间短于灭活组,MFD高于灭活组(P<0.05);绘制ROC曲线显示,达峰时间、增强时间、始退时间、廓清时间及MFD预测PHC患者介入治疗后肿瘤活性的AUC均>0.70,且相较于单独检测,联合检测价值更高(P<0.05);绘制决策曲线,结果显示,在阈值0.004~1.000范围内,CEUS血流灌注参数联合评估PHC患者介入治疗后肿瘤活性的净收益率优于单独的净收益率。结论 CEUS血流灌注参数中达峰时间、增强时间、始退时间、廓清时间及MFD可有效反映PHC患者的肿瘤活性,CEUS血流灌注参数对评估PHC患者介入治疗后肿瘤活性具有一定价值。Objective To explore the value of contrast-enhanced ultrasound(CEUS)perfusion parameters based on decision curve analysis in evaluating tumor activity in patients with primary liver cancer(PHC)after interventional therapy.Methods A retrospective study was conducted to select the clinical data of 86 patients with PHC who underwent transcatheter arterial chemoembolization(TACE)in the hospital from May 2022 to May 2023 as the study subjects.Digital subtraction angiography(DSA)was used to observe the staining of the lesions and group them.The clinical data of PHC patients with tumor staining were included in the residual group,and the clinical data of PHC patients with completely inactivated lesions were included in the inactivated group.Baseline data and CEUS perfusion parameters were compared between the two groups.The receiver operating characteristic(ROC)curve was used to evaluate the value of CEUS perfusion parameters in predicting the tumor activity of PHC patients after interventional therapy.The decision curve was used to analyze the value of CEUS perfusion parameters in evaluating the tumor activity of PHC patients.Results At 1 month after interventional therapy,there were 37 cases of residual tumor and 49 cases of inactivated tumor in PHC patients.The diameter of the lesion in the residual group was longer than that of the inactivated group.The proportion of children-pugh grade B,lesions≥2 and drinking habits in the residual group was higher than that in the inactivation grou(P<0.05).The peak time,enhancement time,withdrawal time and clearance time of the residual group were shorter than those of the inactivated group,and the MFD was higher than that of the inactivated group(P<0.05);ROC curve showed that the AUC of peak time,enhancement time,withdrawal time,clearance time and MFD in predicting tumor activity after interventional therapy in PHC patients were all>0.70,and the value of combined detection was higher than that of single detection(P<0.05);The decision curve was drawn.The results showed that in

关 键 词：原发性肝癌 术后 超声造影 决策曲线 肿瘤活性 

分 类 号：R735.7[医药卫生—肿瘤]